Shoulder SLAP and biceps tendon repair

The increasing number of arthroscopic repairs of superior labral lesions anterior to posterior (SLAP) expresses a rising comprehension of pathopysiology and pathology in SLAP tears. At first, the classification of SLAP lesions included 4 types, by now, 10 types exist. While physical examination often remains unspecific, soft tissue imaging such as direct and indirect magnetic resonance arthrography (MBA) advanced and has contributed to improvement in detection of SLAP lesions. Treatment of SLAP lesions demands a profound knowledge of epidemiology, anatomy and biomechanics. Normal variants such as the sublabral recess, the sublabral hole, the Buford complex and other less common variants have to be differed from pathologic findings; concomitant lesions as rotator cuff injuries, Bankart lesions and perilabral cysts should be detected and need to be included in the therapeutic considerations. Numerous surgical techniques and various anchorage materials have been implemented in operative treatment of SLAP lesions. To avoid postoperative persistent pain and inability to return to previous level of sports, a thorough analysis of all existing findings should be effected particularly in overhead athletes. Standardised algorithms in treatment of SLAP lesions do not exist yet; further investigations are lacking to increase the likelihood of a successful return to pre-injury activity.